This review focuses on the most common cystic pancreatic lesions and neoplasms (i.e. pseudocysts, intraductal papillary-mucinous neoplasms, mucinous cystic neoplasms, serous cystic neoplasms, solid pseudopapillary neoplasms and ductal adenocarcinomas with cystic features) and discusses their clinicopathological features. The progress made in recent years has made it possible to clearly distinguish between the various entities and to unravel some of the problems involved.